Ulrich J Sachs1, Jürgen Bux. 1. Institute for Clinical Immunology and Transfusion Medicine, Justus Liebig-University, Giessen, Germany. ulrich.sachs@immunologie.med.uni-giessen.de
Abstract
BACKGROUND: TRALI is a serious complication of transfusion. WBC antibodies have been associated with TRALI. The importance of such antibodies for the transfusion of granulocytes is unknown. CASE REPORT: A patient with hematologic malignancy and neutropenia-associated pneumonitis received 2 units of granulocytes despite a positive serologic cross- match. She developed severe TRALI after the second transfusion. RESULTS: The recipient's serum was reactive with immobilized HLA class I antigens from donor cells in a glycoprotein-specific assay. With an absorption-elution technique, at least anti-HLA-A2 could be identified as one of the donor-reactive antibodies in the recipient's serum. CONCLUSION: Granulocyte-reactive antibodies are associated with TRALI in an alloimmunized patient receiving granulocyte transfusions. Performing a cross-match procedure may be helpful in preventing severe pulmonary reactions. Additional data are required to determine whether cross-matching as a regular practice in granulocyte transfusions would be beneficial for patients.
BACKGROUND: TRALI is a serious complication of transfusion. WBC antibodies have been associated with TRALI. The importance of such antibodies for the transfusion of granulocytes is unknown. CASE REPORT: A patient with hematologic malignancy and neutropenia-associated pneumonitis received 2 units of granulocytes despite a positive serologic cross- match. She developed severe TRALI after the second transfusion. RESULTS: The recipient's serum was reactive with immobilized HLA class I antigens from donor cells in a glycoprotein-specific assay. With an absorption-elution technique, at least anti-HLA-A2 could be identified as one of the donor-reactive antibodies in the recipient's serum. CONCLUSION: Granulocyte-reactive antibodies are associated with TRALI in an alloimmunized patient receiving granulocyte transfusions. Performing a cross-match procedure may be helpful in preventing severe pulmonary reactions. Additional data are required to determine whether cross-matching as a regular practice in granulocyte transfusions would be beneficial for patients.
Authors: Christina Weingarten; Sarah Pliez; Eva Tschiedel; Corinna Grasemann; Carla Kreissig; Michael M Schündeln Journal: Eur J Pediatr Date: 2016-09-08 Impact factor: 3.183
Authors: Lisa K Vande Vusse; David K Madtes; Katherine A Guthrie; Terry B Gernsheimer; J Randall Curtis; Timothy R Watkins Journal: Transfusion Date: 2013-08-27 Impact factor: 3.157